The truth is, this has more to do with problems endemic to very large bureaucracies — where (due to union contracts) it’s virtually impossible to fire anyone — than to recent mismanagement. Make no mistake, this is a huge operation, and the full-time bureaucrats know they can simply ignore and outlast Shinseki, or anyone else who might try to shake things up.

That’s a problem. But couple that with the fact that these institutions were created during a time when survivable combat injuries and life expectancy were vastly different than today — and so was the potential for using technology to treat patients remotely. The world has changed, but the V.A. hasn’t kept pace. Simply put, these sprawling bureaucracies are running on 20th century inertia — in a 21st century world.

It’s also fair to say that Obama didn’t fix the problem. But, in fairness, it’sgoing to take more than mere window-dressing — more than a few “show trial” resignations — to solve this problem. It’s high time for Congress to radically rethink how we should be taking care of our veterans, and to radically restructure the V.A.

It’s also worth noting another inherent conundrum: With so many facets of big government to manage, things must go dramatically wrong in any given area before our leaders have either the inclination or the political capital necessary to take dramatic steps (such as are now obviously needed). The “squeaky wheel gets the grease,” and I suppose this is especially true in large organizations that naturally prefer stasis. The car has to completely break down before anyone will take it to the shop.

So let’s revisit some of the many warning “check engine” lights that have been ignored, shall we?

The V.A. story, of course, first exploded after CNN reported that “At least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list.”

Back in March — before the Phoenix scandal broke — Senators Casey and Heller released the 21st Century Veterans Benefits Delivery Act. “The backlog has been a persistent and inexcusable problem,” said Sen. Casey. “Our Nation’s heroes shouldn’t have to wait for months or more for their claims to be addressed.

So yes, there were warning signs. But the real story isn’t about poor management or a lack of oversight. No, the real story is about how these bureaucracies are in dire need of a radical overhaul. And, perhaps, we ought to use this as a teachable moment before we repeat this mistake on a larger scale.

If you want to know what government-run health care looks like, just look at the V.A.